John Joseph Werner, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

008490 Issued in NY

Practice address

2000 Deer Park Ave
Box 326
Deer Park, NY 11729-2701

Phone

(631) 667-3667

NPI assigned

Dec 29, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972669323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 RIDGEFIELD RD",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211505",
            "telephone_number": "631-757-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 DEER PARK AVE",
            "address_2": "BOX 326",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292701",
            "telephone_number": "631-667-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00926036",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "008490",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer J Walsh, R.D.,CDN
• Lauren P Wamp
• Eloise Ward
• Sharesse Washington, LPN
• Stacy Wedin-Sandkuhl, DDS
• Erika D Wick
• Nerissa Williams
• Renee Williamson
• Debra Marie Willliams, MS
• Lisa A Winston, R.N.

• Clinical Psychologist in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.